1. Building Healthier Neighbourhoods in Penetanguishene Charles Gardner, MD, CCFP, MHSc, FRCPC Medical Officer of Health

2. The Town of Penetanguishene …has a vision for its future design

3. …and is considering changes to its streetscapes.

4. Working Together March 2011- Active Transportation Workshop (conjunction with Townships of Tiny and Springwater) June 2011- iCANwalk campaign October 2013- Community Design Workshop with Dan Burden - development of Design Standards December 2013- Penetanguishene Trails Committee July 2014- SMDHU provided input into the Recreation and Community Services Master Plan

5. What will be the impacts on health?

6. Community design is a public health priority Many of our health challenges are related to how we have built our communities.

7. Dramatic Increase in Obesity

8. Increasing Obesity in Simcoe County

9. Increasing Diabetes

10. Increasing Prevalence of Diabetes in Simcoe Muskoka

11. Physical activity reduces… Heart disease Falls and injuries Obesity High blood pressure Adult-onset diabetes Osteoporosis Stroke Depression Colon cancer Premature death

12. …YET WE HAVE ENGINEERED PHYSICAL ACTVITY OUT OF OUR LIVES

13. Many have made the connection World Health Organization – European transportation and physical activity collaboration Ontario Medical Association – obesity and air quality reports Ontario College of Family Physicians reports on Urban Sprawl Ontario Chief MOH reports in 2004 and 2009 The Province of Ontario – Places to Grow Ontario Professional Planners Institute Heart and Stroke Foundation Canadian Index of Wellbeing Canadian Medical Association – built environment review paper Ontario Public Health Sector Strategic Plan Reports of many local Public Health Units

14. Physical Activity- Walkable Communities An analysis of studies in 6 communities found that on average, residents in highly- walkable neighbourhoods took twice as many walking trips as people in less walkable neighbourhoods. Most of the increase was due to walking for errands or to go to work.[1][1] [1] Saelens, B.E., Sallis, J.F., & Frank, L.D., Environmental Correlates of Walking and Cycling: Findings From the Transportation, Urban Design and Planning Literatures,” Annals of Behavioural Medicine, 2003.

15. Obesity – Proximity and Mixed Use People who live in neighbourhoods with a mix of shops and businesses within easy walking distance have a 35% lower risk of obesity. [1] [1] [1] Frank, L.D., Andresen, M.A., & Schmid, T.L., Obesity Relationships With Community Design, Physical Activity, and Time Spent in Cars”, American Journal of Preventive Medicine, 2004.

16. Walkable destination in Ontario Transportation Behaviors and Health Outcomes by Residential Density and Availability of Walkable Destinations. Booth GL, Glazier RH, Creatore MI, Weyman JT, Fazli G, Matheson FI, et al. (2014) Density, Destinations or Both? A Comparison of Measures of Walkability in Relation to Transportation Behaviors, Obesity and Diabetes in Toronto, Canada. PLoS ONE 9(1): e85295 doi:10.1371/journal.pone.0085295

17. Recreation alone is not the answer

18. Utilitarian versus Recreational Activity SOURCE: DOWELL D, OLSON, COREY C, HOLDER-HAYES E, KHEIRBEK I, CAFFARELLI A. HEALTH BENEFITS OF ACTIVE TRANSPORTATION IN NEW YORK CITY, NYC VITAL SIGNS SPECIAL REPORT 2011, 10(3): 1-4.

19. Injuries – Traffic Calming Traffic speed increases pedestrian injury and mortality risk. 1 Traffic-calming design features such as street trees, on-street parking, narrower streets and landscaping reduce traffic speeds. 2 Dedicated bicycle lanes and paths, sidewalks and traffic circles reduce risk to pedestrians and cyclists. 2 1.Handy, Susan, Community Design and Physical Activity: What Do We Know?—And What Don’t We Know?, University of California Davis, May 2004. 2.Retting RA, Ferguson SA, McCartt AT. A review of evidence-based traffic engineering measures designed to reduce pedestrian-motor vehicle crashes. Am J Public Health 2003; 93(9):1456-1463.

20. More walking/cycling in the Netherlands…. From: Promoting Safe Walking and Cycling to Improve Pubic Health: Lessons from the Netherlands and Germany. Pucher, J, & Dijkstra, L. American Journal of Public Health. Public Health Matters, Sept 2003, Volume 93, No. 9.

21. …because it’s a lot safer

22. Traffic Volume & Air Quality Over 350 deaths annually in Simcoe Muskoka from air pollution (OMA estimates) Living near heavy traffic = 2.5 years loss of life (Finkelstein et al, Am J Epi, 2004) Atlanta Olympics 1996: increased public transportation = 22% reduction in traffic, 28% reduction in ozone, 41.6% reduction in ER visits for asthma (Friedman et al, 2001)

23. Walking Access for Lower Income People

24. A healthy community provides opportunities… For people to walk and cycle to work. For children to be able to walk and bike safely to school. To be connected to parks, other neighbourhoods and trails. To enjoy the natural environment such as water, farmland and green space. To have access to healthy foods that are fresh and affordable in every neighbourhood. To have sidewalks, pathways, trails and bike lanes that are inviting, accessible, safe and connected to amenities and public transit. For connection to community gathering places. Has sufficient density to support all of this.

25. …you need walkable access to services in every neighbourhood. Whether you are 8 or 80…

26. Final Thoughts Community design is important for people’s health. People are safer, more active and healthier with streetscapes that support walking and cycling. Penetanguishene is making advances on healthy community design.